Alicia Leigh Jensen, OTR/L
Individual provider Active NPI Occupational Therapist · South Range, WI
NPI 1811570799 · NPPES record last updated Apr 29, 2021
Key facts
- NPI
- 1811570799
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Occupational Therapist 225X00000X
- Practice address
- 8274 E San Rd
South Range, WI 54874-8621 - Phone
- (715) 398-3523
- NPI assigned
- Apr 29, 2021
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WI
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20241104003370 | WI | Practitioner - Occupational Therapist in Private Practice | 7214460872 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Burnett Medical Center Inc | Current | Accepting new patients | |
| Burnett Medical Center Inc | Past | Accepting new patients |
Locations
257 W Saint George Ave
Grantsburg, WI 54840
Phone (715) 463-5353
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | Yes |
Addresses
Primary practice location
8274 E San Rd
South Range, WI 54874-8621
Mailing address
8274 E San Rd
South Range, WI 54874-8621
Other providers in South Range, WI
- Taylinn Elizabeth Frana
- Cassandra Marie Gray
- Kelsey C Gunderson
- Kala Marie Hanson
- Laurie Anne High
- Shantrice Lafave
- Jennifer McGrath
- Middle River Rehabilitation LLC
- Rachel Larae Piotrowski
- Harly Prentice
All providers in South Range, WI · Occupational Therapist in Wisconsin
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 29, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.